December 11, 2018

The 2017 Maryland Report on the Health Care Appeals & Grievances Law, MSAR #6, was recently issued on December 1, 2018. To view the report, please click here.

November 26, 2018

Section 4530.40 has been amended to make the deadline for health carriers to submit an external review report to the Director of Insurance consistent with PA 99-537, which became effective January 1, 2017. To view the amendment, click here.

November 19, 2018

Part 4520 has been amended to recognize the Accreditation Association for Ambulatory Health Care among the list of accreditors from which utilization organizations may receive accreditation and qualify for reduced registration and renewal fees. To view these amendments, click here.

October 30, 2018

On October 11, 2018, Commissioner of Workers’ Compensation Cassie Brown adopted amendments to 28 Texas Administrative Code (TAC) §134.600, Preauthorization, Concurrent Utilization Review, and Voluntary Certification of Health Care. The adopted amendments were filed with the Office of the Secretary of State on October 12, 2018, and published in the October 26, 2018 issue of the Texas Register. […]

October 29, 2018

Rhode Island Department of Health is proposing to repeal 216-RICR-40-10-20 because the statutory authority under which it was created has been repealed and transferred to the Rhode Island Office of the Health Insurance Commissioner. To view the status of this regulation, click here.  

October 5, 2018

The New Jersey Department of Banking and Insurance, Division of Insurance, Consumer Protection Services, Office of Managed Care, issued its semi-annual report to the Legislature on activities related to the Independent Health Care Appeals Program from January 1, 2018 through June 30, 2018. To view the report, click here.

October 5, 2018

2018 La. SB 336, effective date June 30, 2018, amended Louisiana Annotated Statutes, Louisiana Revised Statutes, Title 23 Labor and Workers’ Compensation, Chapter 10 Workers’ Compensation, Part 2 Benefits, Subpart A General Provisions – La. R.S. 23:1203.1. Applicable sections were updated in the Louisiana WCUM module page; however, to review the entire enacted bill, click […]

October 4, 2018

On September 11, 2018, the Insurance Division issued Bulletin B 18-13. The bulletin stated that the Alaska Division of Insurance will resume oversight of the external review process on October 1, 2018. To view this bulletin, click here.

September 28, 2018

The Colorado Department of Regulatory Agencies, Division of Insurance, adopted new Rule 4-7-03: Standards for Health Maintenance Organizations, effective June 1, 2018. The purpose of the regulation is to establish standards to ensure that each HMO licensed in Colorado delivers quality health care services and to ensure that each HMO seeking licensure in Colorado has […]

September 25, 2018

On August 23, 2018, the California Supreme Court ruled in favor of a utilization review (UR) physician accused of malpractice. Specifically, the Court unanimously held that a claim for malpractice against a UR physician for injuries arising from a review decision for the treatment of a compensable injury could not be maintained under the workers’ […]